Discordant thyroid function tests are routinely encountered in clinical practice. Differential diagnoses include acute thyroxine (T4) ingestion, laboratory interference from heterophilic antibodies, thyroid hormone resistance, thyroid-stimulating hormone (TSH)-secreting pituitary adenomas, and T4 protein binding abnormalities. The impact of abnormal binding proteins may be less recognized since widespread use of free T4 (FT4) assays compared to older total T4 assays.

Objectives. Associations between thyroid function and nonalcoholic fatty liver disease (NAFLD) are unknown in childhood. Thus, the aim of the present study was to investigate in 402 consecutive overweight/obese children the association between thyroid function tests and hepatic steatosis as well as metabolic variables. Methods. Hepatic steatosis was diagnosed by ultrasound after exclusion of infectious and metabolic disorders. Fasting serum samples were taken for determination of thyroid function (TSH, FT4, and FT3), along with alanine aminotransferase (ALT), lipid profile, glucose, insulin, and insulin resistance (IR). Results. Eighty-eight children (21.9%) had TSH above the normal range (>4.0 mIU/L). FT3 and FT4 were within the reference intervals in all subjects. Elevated TSH was associated with increased odds of having hepatic steatosis (OR 2.10 (95% CI, 1.22-3.60)), hepatic steatosis with elevated ALT (2.42 (95% CI, 1.29-4.51)), hypertriglyceridemia, elevated total cholesterol, and IR as well as metabolic syndrome (considered as a single clinical entity), after adjustment for age, gender, pubertal status, and body mass index-SD score (or waist circumference). Conclusions. In overweight/obese children, elevated TSH concentration is a significant predictor of hepatic steatosis and lipid and glucose dysmetabolism, independently of the degree of total and visceral obesity.

Asfotase alfa is the only approved treatment that can normalize mineralization in patients with hypophosphatasia (HPP). Its interference in alkaline phosphatase (ALP) dependent immunoassays has been reported.

Polybrominated diphenyl ethers (PBDEs) are flame-retardant chemicals that are added to many consumer products. Multiple animal studies have shown PBDEs to be thyroid hormone (TH) disruptors. Epidemiologic evidence of PBDE exposure associated with TH disruption has been inconclusive.

The IFCC Committee for Standardization of Thyroid Function Tests aims at equivalence of laboratory test results for free thyroxine (FT4) and thyrotropin (TSH).

Thyrotoxicosis is a clinical state that results from inappropriately high thyroid hormone action in tissues. Although it is one of the common endocrine disorders, there is scarcity of data on the management of thyrotoxicosis in Africa, particularly in Ethiopia. The aim of this study was to investigate treatment outcomes and determinants of treatment outcomes among hyperthyroid patients on antithyroid drugs attending a teaching hospital in Ethiopia.

Evaluation of thyroid function is often requested and therefore defining paediatric reference intervals (RIs) is of vital importance. Currently, there is a distinct lack of paediatric RIs for thyroid function tests in Croatia. Thus, we established RIs for thyroid stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3) and free thyroxine (FT4) in the Croatian paediatric population.

The lack of syndrome-specific reference ranges for thyroid function tests (TFT) among pediatric patients with Down syndrome (DS) results in an overestimation of the occurrence of hypothyroidism in this population.

An Israeli national survey found that 85% of pregnant women had urinary iodine content (UIC) levels below the adequacy range (<150 µg/L). Widespread desalinated water usage and no national fortification plan are possible causes. Studies assessing relationships between iodine status and maternal and neonatal thyroid function provided varying results. Our aims were to determine whether iodine deficiency was associated with altered maternal or neonatal thyroid function and the factors leading to iodine deficiency.

Low TSH is associated with frailty in the older adult. We studied whether low TSH is an independent marker of frailty or is an indicator of subclinical hyperthyroidism, which in turn predicts frailty. Of outpatient veterans seen between January 2005 and December 2016, we identified 100 patients aged ≥60 years with two low TSH (<0.5 µIU/ml) and one fT3 measurement and 50 matched controls (TSH 0.5-5.0 µIU/ml). We used a deficit accumulation approach to create a frailty index (FI). The higher the FI, the more likely (p<0.001) that patients had expired. Patients with low (0.31 ± 0.11 µIU/mL) versus normal (1.84 ± 0.84 µIU/mL) TSH had higher mean FI compared to controls (0.25 ± 0.12 vs. 0.15 ± 0.07, p < .001). Low TSH was significantly associated with frailty (p < .001), independent of age. However, lower TSH was not associated with higher fT3 or fT4 levels. There was a nonsignificant inverse association of fT3 levels with FI (p = .13), which disappeared when adjusted for age. Similar to prior studies, low TSH was associated with frailty. However, neither fT3 nor fT4 predicted low TSH or FI, suggesting that the association of low TSH with frailty is not due to subclinical hyperthyroidism, but perhaps to effects of comorbidities on TSH secretion.

Recent guidelines recommend establishing a local reference interval (RI) for thyroid function. We aimed to establish trimester-specific RIs for thyrotropin (TSH) and free thyroxine (FT4) in a cohort of healthy pregnant women in Catalonia (Spain).

Background: Thyroid hormone and cortisol levels can change during a course of illness. Our study was conducted to assess the ability of the level of these hormones to predict mortality among intensive care unit (ICU) patients. The added predictive value of these hormones with APACHE II scores was also evaluated. Methods: Thyroid hormones and random cortisol levels in adult ICU patients were collected on admission. Multivariate logistic regression analysis was used to assess the relationship between hormone levels and mortality. The added value of the mortality predictive ability was determined by area under the receiver operating characteristic (AuROC). Results: A total of 189 patients were included in the study. Free T3 and serum random cortisol levels were statistically significantly related to ICU mortality with OR 0.51 (0.28, 0.97), p = 0.047 and OR 1.02 (1.01, 1.04), p < 0.002, respectively. Free T3 and serum random cortisol significantly enhanced the predictive performance of APACHE II scores with an AuROC of 0.656 (non-added value model) versus 0.729 (added value model), p = 0.009. The scoring system was created with a total score that ranged from 1 to 14. A score above 7.0 indicated a high mortality rate with a sensitivity of 81.5% and a specificity of 33%. Conclusions: Serum free T3 and cortisol levels are significantly associated with ICU mortality and can enhance the ability of APACHE II scores to predict ICU mortality.

Genome-wide association studies in adults have identified 42 loci associated with thyroid stimulating hormone (TSH) and 21 loci associated with free thyroxine (FT4) concentrations. While biologically plausible, age-dependent effects have not been assessed. We aimed to study the association of previously identified genetic determinants of TSH and FT4 with TSH and FT4 concentrations in newborns and (pre)school children.

Hypothyroidism is an important risk factor for cardiovascular diseases, and autoimmune thyroiditis (AIT) is the leading cause of hypothyroidism. Recent studies showed that even AIT patients with euthyroidism still had an increased number of early atherosclerotic lesions. However, the precise mechanism is not yet known. This study aimed to investigate the association of thyroid function, thyroid autoimmunity, and cardiometabolic risk factors in non-obese AIT patients with euthyroidism.

The effects of COVID-19 on the thyroid axis remain uncertain. Recent evidence has been conflicting, with both thyrotoxicosis and suppression of thyroid function reported.

A high activity of the deiodinase type 2 has been proposed in overweight, obese, and smoking pregnant women as reflected by a high triiodothyronine (T3)/thyroxine (T4) ratio. We speculated how maternal adiposity and smoking would associate with different thyroid function tests in the early pregnancy.

The contribution of CXCL12/CXCR4/CXCR7 axis to cancer progression has been increasingly recognized. However, its role in thyroid cancer development remains unclear. The present study aimed to examine the expression and function of CXCL12 and its receptors in thyroid cancer. The expression of CXCL12/CXCR4/CXCR7 in human tissue specimens of papillary, follicular, medullary, and anaplastic thyroid carcinoma, follicular adenoma, Hashimoto's thyroiditis and nodular goiter were examined by immunohistochemistry using a tissue microarray. CXCR4 and CXCR7 were over-expressed in human thyroid cancer cells K1 by transduction of recombinant lentivirus. The effect of overexpression of CXCR4 and CXCR7 on K1 cell proliferation and invasion and the molecular mechanism underlying the effect were investigated. CXCL12 was exclusively expressed in papillary thyroid carcinoma tissue but absent in other types of thyroid malignancies and benign lesions. CXCR7 was widely expressed in the endothelial cells of all types of malignancy but only occasionally detected in benign lesions. CXCR4 was expressed in 62.5% of papillary thyroid carcinoma tissue specimens and in 30-40% of other types of malignancy, and it was either absent or weakly expressed in benign lesions. CXCL12 stimulated the invasion and migration of K1 cells overexpressing CXCR4, but did not affect K1 cells overexpressing CXCR7. K1 cell proliferation was not affected by overexpression of CXCR4 or CXCR7. Overexpression of CXCR4 in K1 cells significantly increased AKT and ERK phosphorylation and markedly induced the expression and activity of matrix metalloproteinase-2 (MMP‑2). Thus, CXCL12 may be an effective diagnostic marker for papillary thyroid carcinoma, and CXCL12/CXCR4/CXCR7 axis may contribute to thyroid cancer development by regulating cancer cell migration and invasion via AKT and ERK signaling and MMP-2 activation.

Thyroid dysfunction accounts for majority of endocrine disorders. In sub-Saharan Africa Graves' disease and hypothyroidism have accounted for 13.1% and 8.8% while the burden of thyroid disorder has ranged from 6.18 to47.34% among countries in the Arab world. The cost for a primary thyroid test done to evaluate the gland function constituted a large proportion of the public health budget. For instance, 10 million thyroid functions have been done each year by laboratories which cost 30 million UK pounds, and they represent 8% of laboratory charge in the US. When a TSH-only protocol (guideline) was used, 95% of the requests were sufficient for diagnosis without requiring further tests, thereby resulting in 50% savings on FT4 reagent and reducing the annual TFT reagent cost by 25%. This is an original study, and its objective was to assess the ordering pattern of TSH tests and their cost-effectiveness in patients' samples referred to ICL from Addis Ababa health facilities between July2015 to June 2016.

Previous studies have suggested that cholesterol may influence thyroid function. Since statins are widely used for their cholesterol-lowering effect, we aimed to assess the association between statin use and thyroid function, and also to explore the role of the cholesterol-lowering effect in it.

 Thyroid diseases are the second most common endocrine disorders in the reproductive period of women. They can be associated with intrauterine growth restriction (IUGR), preterm delivery, low Apgar score, low birthweight (LBW) or fetal death. The aim of the present study is to explore thyroid dysfunction and its relationship with some poor perinatal outcomes (Apgar Score, low birthweight, and preterm delivery).